WORLD EMERGENCY MEDICINE SOCIETIES

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miércoles, 15 de julio de 2015

Bloqueos fasciculares

"There are few things in ECG interpretation more irritating to a junior learner than fascicular blocks. You might find yourself asking whether the pattern is qR. Or maybe it’s rO. sO? ss? And what are these fascicle things anyway?

In this article, we will briefly explore the physiology of cardiac depolarization, with and without fascicular blocks. Then we get to the important stuff: how to recognize these syndromes on ECG, and how to treat them in the emergency department.

Conclusion

The anatomy of the cardiac fascicles is complicated. As emergency room physicians, we need to recognize fascicular blocks on ECG, and implement pacing as therapy for symptomatic bradycardia caused by a trifascicular block,. Patients with new complete trifascicular blocks or incomplete trifascicular blocks (such as a Mobitz II pattern) need urgent referral to an electrophysiologist for pacemaker implantation."